Latest Comments by bbuerke

Latest Comments by bbuerke

bbuerke 1,932 Views

Joined Jun 11, '12. Posts: 37 (76% Liked) Likes: 178

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  • 8

    Horrible. Goes to show how seriously nurses take their jobs, and when there's an error how devastating it can be. She is not the first, nor I'm sure the last, to take her own life after an event/error. Hospitals absolutely need to provide support to nurses after events like this.

    One correction though, it was my understanding that Jacintha was not the nurse caring for Kate. Rather, the nurse who transferred the call to Kate's nurse:

    "The mum-of-two had been duped into putting through a hoax call to Kate’s nurse from Aussie DJs pretending to be the Queen and Prince Charles.
    Devoted Jacintha was on reception when she took the call from 2Day FM pranksters Mel Greig and Michael Christian and transferred them to another nurse who gave out sensitive information about sick Kate."

    Jacintha Saldanha: First picture of nurse found dead in suspected suicide after falling victim to Australian radio prank call - Mirror Online

    I don't know why, but this makes it even more sad to me. She wasn't even the one who divulged information over the phone, and yet she still took her own life. Really highlights how something like this can be devastating to a nurse, not just professionally, but personally as well.

  • 0

    It says on their wrist band "DNR" or DNR/DNI" or "DNI".
    How does that work? If someone stops breathing but has a pulse, unless you do something about it, eventually they will have no pulse. Are you supposed to just stand around and wait for the pulse to stop, then do compressions because they are not a "DNR" as well? I realize I'm being nit-picky, but this image just made me think of Peter Sellers in Murder By Death:

    "Not breathing. No pulse. If condition does not change, he'll be dead!"

  • 1
    wooh likes this.

    quote from akulahawk:

    A DNR is very specific about what's not allowed. No CPR. No TCP. No intubation. No Assisted Ventilation. No cardiotonic drugs.
    I don't know that this is universal yet. I know a lot of hospitals are moving to this model for definition of DNR, but I don't think all have caught up yet. Some people interpret DNR as no compressions, no intubation only, but meds and shocks/TCP are OK depending where the person falls in the ACLS protocol.

    Would be interesting to see the differences between states/facilities.

    quote from music in my heart:

    still, if the patient is not a DNR or "no CPR" then I think we're ethically bound to beat the snot out of them even though there's very little chance they'll even make it to the ICU and ZERO chance that they will ever get out.
    THIS*** is exactly what's wrong with end of life care in this country. It is the one area where we are, as you put it, ethically bound to provide substandard/ineffectual care. In all other areas of what we do we are ethically bound to provide the most effective, evidence based practice, but not here. This absolutely has to change, and as I said before, should come from the organizations/experts who drive practice through protocols and standards of care. It will only change if we change our protocols. Working in oncology I've worked with a few attendings who say, "when they go, call the code but page me too. I'll come over and pronounce them." That way we don't go on and on in a futile effort, and the family knows we tried. It's not a slow code per se, but maybe a "short code"? We still go all out, but at least someone has the good sense to put a stop to it at a reasonable point. I think that's the main problem with codes - they can go on indefinitely if you let them. Meanwhile the person's chances of meaningful recovery decrease with every passing minute. There really should be a time limit on those things.

  • 8

    Quote from Samadams8:

    The whole thing sounds screwy. Betcha somehow you weren't liked or they found someone they liked better for some reason, or there is some kind of game going on. Your mistakes were not Fire-worthy in the bigger scheme of things, especially for being a new nurse.There's a game afoot. I've seen this at other places.This sounds like a potentially toxic environment. Seriously. The whole thing is asinine, and I wouldn't want to work there....and I'm a very good nurse. Something is wrong there.Considered yourself blessed. Write a strong letter to admin and appropriate people w/i this place, and then don't look back.I'm not saying you were right, but I have seen much worse mistakes, and nurses and doctors that have made them grew to be great in their roles. This is a bad environment. The way it sounds, they would have just continued to make your life there miserable. You can do much better..seriously...I'm not talking sour grapes, sweet lemons.
    I'm a little disturbed by this line of thinking. It sounds, I don't know, paranoid maybe? I don't mean to pick on you in particular, but I've noticed this type of general theme a lot on Allnurses, and I feel the need to say something, because it is potentially damaging.

    I know a lot of people come on here to vent, and we want to to give them our support and lift them up. I get that. However, acting like the people who are venting are 110% A-OK/perfect/blameless while big, fat, evil, maniacal administrators/managers/higher-ups/bigwigs/"the powers that be" are setting them up to fail, is frankly, not realistic. It perpetuates the attitude of "us vs. them" instead of holding people accountable for their actions and truly helping them. That is, helping them emotionally (through understanding, support, and encouragement) and professionally (by helping them to acknowledge their own short comings and make a genuine effort to improve). Blaming others, especially when we only hear one side of the story, does nothing to help an individual improve or reach their full potential. All it does is perpetuate the concept of victimization and create a form of classism within nursing that is not helpful.

    I am not naive enough to think that management are all angels, nor am I cynical enough to think they are devils either. We all need to start looking at situations from the other person's perspective (yes, even managers/administrators) or we will simply keep perpetuating all these negative stereotypes about one another.

    That's all for now. This post has been a long time coming, so I appreciate any who read it. Thanks for the vent.

  • 3

    I'm so sorry this happened to you. You sound like someone whose heart is in the right place, judging by your level of humble introspection - very mature, and not often the case when someone is fired (people always want to blame the manager or someone else instead of taking responsibility for their own actions).

    These are all qualities that will serve you well in your next job. I also have to wonder if it was more than just these few incidents. You admit to a lack of critical thinking in these circumstances, are there any other occurrences that demonstrated a persistent lack of critical thinking throughout orientation? If so, this would be another area on which to reflect before you start a new job. Some of the new grads we had to let go where I work were really sweet people who were fastidious and so afraid of doing the wrong thing. We were all heartbroken about it because we so wanted it to work and were really rooting for them. Gave them extra time, etc. Managers do want their employees to succeed, believe it or not. Unfortunately, repeated patterns of behavior despite remedial training still did not yield the results we needed for these new nurses to practice competently or independently. Sad for everyone involved, but not all settings of nursing are appropriate for everyone. I firmly believe that anyone can find their niche in nursing, it may not be the one you initially want or expect, and that's OK.

    Chin up, reflect on your strengths and weaknesses, and keep searching for your nursing "home". I do hope you find it soon.

  • 0

    So glad I'm not the only one who didn't have clinical prep work. As I was reading this post I was thinking "what the?!?!? Did I miss something when I was in nursing school?"

    The idea of coming in the day before seems preposterous to me, for the reasons already mentioned. Also, I have to wonder how that affects learning. I am an experiential learner, and we would do a report every day after clinical. It was much easier to apply what we had learned in class to the patient's situation after having some experience with the patient, really helped to put all the pieces together. You don't show up to work knowing what patients you have ahead of time, so why should you in school? It doesn't reflect the real world...

  • 0

    I don't do obligatory gift giving. Not for Christmas, birthdays, anything. It feels fake to me. If I see something I think someone will enjoy, I'll get it for them, just because, doesn't matter if it's 12/25 or 6/17. Makes it more genuine that way. Occasionally if I find something and it's close to a holiday/special occasion I'll hold on to it for the event but usually just give it right away.

    Maybe this makes me a Scrooge but mostly it's because shopping gives me a ton of anxiety. I am always terrified the person won't like their gift and it will all have been a wasted effort. I also don't enjoy receiving presents - I am a simple person and most gifts that people get me never get used, so I would frankly rather not receive anything at all. The most appreciated present is just that - presence. I would much rather spend quality time with friends and loved ones than have them waste their time and money on shopping. Also, kind, heartfelt words mean more to me than anything else. Tell me how you feel, what you enjoy, what you appreciate about our relationship. That is life-affirming, and something special shared between loved ones that no one can ever take away.

  • 0

    Had a co-worker who was a total germaphobe. The thing was not only did she have all those rituals, she would talk about it incessantly, how everything grossed her out. Seriously, it would occupy a large percentage of conversation with this woman and it really made me want to ask "How/why are you a nurse? Clearly working in the hospital is exacerbating your neuroses..." I feel bad for these folks, OCD is terrible and can really cause major anxiety and impair a person's ability to function. My poor cousin's hands are always bloody from excessive handwashing with very hot water.

  • 0

    Jean Marie,

    What a sweet story. I think all children should have exposure to those who are less fortunate, whether they are poor, sick, elderly, disabled, etc. It builds empathy and compassion at a young age, and kids don't get enough exposure to that sort of thing anymore. I used to visit the elderly homebound with my mom when I was little, and it definitely shaped the way I view the world.

    Your story also reminded me of when I was a little girl, my dad was out of the country and my mom was in the hospital. My sister, 14 years my senior, took me with her to some college classes. Most professors I am sure cocked an eyebrow at the five year old sitting in the back of a chemistry class, but we didn't have any other options. I remember her classmates giving me magazines to look at, and putting on a white coat (which was huge on me) for lab. I got the sense that the students enjoyed me being there - they thought it was cute, my sister was proud of me, and I felt like a big girl to be with them - definitely a confidence and self-esteem builder. I'm sure your children felt the same, and it is clear you are very proud of your children and they way they behaved that Christmas, as you should be.

    I guess there's a lot to be said for "bring your kids to work day", especially on Christmas

  • 1
    echoRNC711 likes this.

    It's great that nurses are consistently recognized as the most trusted profession, as I think we should be. However, when considering why some of the others are ranked so low, you have to consider publicity. Clergy for example, let's face it, the sex scandals of the past decade made big headlines and probably did long-lasting damage to the reputation of clergy everywhere. Nurses however, tend to keep a low profile in the media (as far as negativity goes), and when bad things do make the news, it's usually something terrible but unintentional, like those errors with heparin. Sure, you occasionally hear about a nurse acting as an "angel of death" and killing patients, but that is few and far between, and generally chalked up to being a disturbed individual. Never enough for public opinion to condemn the whole profession.

    Lastly, I'm interested in the timing of the survey. Was this after the hurricane when the story of NICU nurses evacuating babies in NYC made headlines? And if it was done this week, after the whole Prince William/Princess Kate debacle, would that have changed people's answers?

  • 8

    cp1024

    This:

    several of my classmates went out drinking during lunch at clinical. They were talking about it openly, and while they were not "drunk" they were too impaired to be in clinical.
    is terrifying.

  • 5
    AGACNPTX, elkpark, KelRN215, and 2 others like this.

    elkpark:

    If it were up to me, I would make the national standard that everyone is a DNR unless there's some darned good reason to resuscitate them (y'know, young, healthy adult, some freak accident with electricity that stopped the heart ... )
    Yes! Coding people is, in a way, fraudulent. It's providing care that has been shown, time and again, to be largely ineffective. How is that practicing evidence based nursing/medicine? It is sooooo expensive, and we are essentially taking our patient's money under false pretenses.

    I've heard of wrongful death and wrongful birth suits before. What about wrongful...life? vegetation? assault and battery? What should we call it when we "bring someone back" only for them to die a slow death later?

    I don't know...maybe down the road, as more evidence is accumulated, the ACLS/BLS protocols can change so as to cut down on this stuff? Such as, unwitnessed inhospital arrest with PEA, no pulse after 2 rounds of epi/CPR, end the code....we'll see. The way things are I think that's our only chance to cut down on all this suffering and waste.

  • 1
    dnurse2b likes this.

    I think the biggest endorsement for any facility comes from the customers. I will never forget when my sister joined the Little Sisters of the Poor. They run nursing homes for impoverished elderly, and they do it with precious few resources (yes, they still go out and "beg"). When we were visiting my sister at one of the facilities a little old lady walked up to me and said "I'm 106. There are several centenarians living here and do you know why? It's because they love us..." Still brings a tear to my eye to this day.

  • 3

    Just to play devil's advocate:

    It's so sad that the US standards in so many vital areas are dropping so fast.
    I have to wonder how much of that stuff is really "vital" anymore. Latin, short hand, and Morse Code used to be all the rage. Now they're "dead" languages. The day may come where cursive writing goes the way of the DoDo and why shouldn't it? The need for cursive was to 1) be faster and 2) prevent ink dripping all over from lifting the quill off the page. The age of ball point pens removed half that need, and word processors removed the other. Printing will do just fine.

    Take it a little further and the age of computers, phones, etc. may remove the need for writing (ie. actual physical "writing") altogether, given enough time. There's not necessarily anything wrong with that, as long as humans are able to communicate effectively by pushing buttons and being able to interpret the output. *That is where the problem lies - the interpretation part. Standardization is a key component to any successful language - people have to agree on what things mean. Not being able to interpret the output, or create output that others can interpret is where we get into trouble. This is what we need to keep in mind when working with patients and colleagues: can they understand the communication, whether written, verbal, or physical demonstration.

  • 1
    teeniebert likes this.

    Thanks for a great post/reminder. This stuff has serious implications for 1) Comprehension of material and 2) How knowledge is disseminated and interpreted. Communication is everything, particularly in regards to patient safety.

    Not to pick on nurses, but do you think the type/style of reading and writing required for the job is a hindrance? So many check boxes, abbreviations, etc. makes it hard to construct much less understand writing with any flourish. I think of my friends with jobs/majors in other fields and I feel like a dummy next to them - they are so well read and write beautifully. I sometimes go back and re-read stuff I wrote in high school and liberal arts college classes and think, "Darn, that was pretty good. Did I really write that?" Don't think I could do it today...the agony/anxiety I'm experiencing over writing in grad school is evidence of the slow and steady decay of these "soft" skills...

    Also, having to proofread the work of class mates is equally painful. We're all grad students, and yikes! Whole sentences/paragraphs that make. no. sense. It's really hard to give positive feedback to someone who has produced something that is essentially unreadable. The nicest way (that I've come up with so far) to give constructive criticism is to say "Always make sure you have someone proofread for you. It can be hard to catch your own mistakes."


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